Shirley A. Hatten, LPN

Individual provider Active NPI Licensed Practical Nurse · Otway, OH

NPI 1508060948 · NPPES record last updated Jun 28, 2018

Key facts

NPI
1508060948
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
088660 (OH)
Practice address
12700 State Route 348
Otway, OH 45657-9528
Phone
(937) 587-2353
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
088660OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 088660 OH Yes

Addresses

Primary practice location

12700 State Route 348
Otway, OH 45657-9528

Mailing address

12700 State Route 348
Otway, OH 45657-9528
Phone (937) 587-2353

Other providers in Otway, OH

All providers in Otway, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.